Infections and acute graft-versus-host-disease (aGVHD) may increase the risk of AKI development in the early period after allo-HSCT. The aim of our analysis was to analyze the relation between infections and aGVHD with AKI in children within 100 days after allo-HSCT.

Material and methods:

Retrospective chart review of pediatric patients who underwent allo-HSCT at Vilnius University Hospital Santaros Clinics during 2011-2017 was performed. AKI was defined using the pRIFLE criteria and only the patients with AKI stage I or higher were considered.Only laboratory confirmed viral and bacterial bloodstream infections were included. Acute GVHD was diagnozed using internationally recognized criteria.

Results:

A total of 45 pediatric patients after allo-HSCT (68.9% boys) with a median (IQR) age of 10.5 (7.5-15.3) years were included into the analysis. AKI occurred in 24 (53.3%) patients.

Patients with AKI had a higher proportion of documented polyomavirus infections (Table). No differences in the frequencies of acute graft-versus-host disease (aGVHD), other viral infections and bacterial bloodstream infections were found in patients with and without AKI (Table).

No AKI (n=21 )

AKI (n=24)

P value

aGVHD, %

10 (47.62%)

13 (54.2%)

0.67

Grade III-IV

3 (14.3%)

7 (29.2%)

0.23

Sepsis, %

10 (47.62%)

17 (71%)

0.11

Viral infections, %

Epstein-Barr viremia

13 (62%)

15(63%)

0.97

Citomegalo viremia

8 (38%)

10 (42%)

0.81

Adeno viremia

2 (10%)

3 (13%)

0.76

Polyomavirus viremia, %

BK

0 (0%)

5 (21%)

0.03

JC

1 (5%)

2 (8%)

1

Polyomavirus viruria, %

BK

13 (14%)

3 (13%)

0.87

JC

1 (5%)

7 (29%)

0.03

Conclusions:

Children with AKI after allo-HSCT had higher proportion of polyomavirus infections. The rates of other viral infections, bacterial bloodstream infections and aGVHD were comparable in patients with and without AKI.